Open AccessShifting concepts in rectal cancer management
Author(s) -
Kosinski Lauren,
HabrGama Angelita,
Ludwig Kirk,
Perez Rodrigo
Publication year - 2012
Publication title -
ca: a cancer journal for clinicians
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 62.937
H-Index - 168
eISSN - 1542-4863
pISSN - 0007-9235
DOI - 10.3322/caac.21138
Subject(s) - colorectal cancer , modalities , neoadjuvant therapy , medicine , cancer , disease , multimodal therapy , adjuvant therapy , treatment modality , intensive care medicine , surgery , social science , sociology , breast cancer
Abstract The management of rectal cancer has transformed over the last 3 decades and continues to evolve. Some of these changes parallel progress made with other cancers: refinement of surgical technique to improve organ preservation, selective use of neoadjuvant (and adjuvant) therapy, and emergence of criteria suggesting a role for individually tailored therapy. Other changes are driven by fairly unique issues including functional considerations, rectal anatomic features, and surgical technical issues. Further complexity is due to the variety of staging modalities (each with its own limitations), neoadjuvant treatment alternatives, and competing strategies for sequencing multimodal treatment even for nonmetastatic disease. Importantly, observations of tumor response made in the era of neoadjuvant therapy are reshaping some traditionally held concepts about tumor behavior. Frameworks for prioritizing and integrating complex data can help to formulate treatment plans for patients. CA Cancer J Clin 2012;. © 2012 American Cancer Society.